Kids First?

Health and Social Care Secretary Jeremy Hunt has been busily briefing that the NHS will get a substantial funding settlement for its 70th birthday, but how should any extra cash be prioritised for maximum benefit? Hunt is fond of saying that patient safety is ‘paramount’, and yet has singularly failed to enforce legally mandated safe-staffing and skill mix levels that are essential to patient safety. Patients, and members of staff, are avoidably harmed every day in health and social care because of staff shortages right across the service. So where should Hunt and NHS England start to reverse this wholescale avoidable harm?

The law, as enshrined in the 1989 Children’s Act, made it clear that “the welfare of the child is paramount”. Adopting this legal principle would mean that in any situation the right of children to be both protected from avoidable harm and to live healthy lives should override all other concerns in health and social care. So how is England complying with this law? Even if in its narrowest interpretation, protecting children from the risk of abuse, services are struggling. A recent survey by the National Network of Designated Healthcare Professionals for Safeguarding Children (NNDHP)

[…..] Read More

We’re Scamming

Many older people resent being called vulnerable, but to scammers they can be easy prey. Whilst car theft and house burglary have become harder due to improved technology and security, there has been a massive growth in relieving older people of their money, secure in the knowledge that they may be considered unreliable witnesses under fierce cross-examination. Professor Keith Brown from Bournemouth University leads research for the Chartered Trading Standards Institute in the field of financial fraud and scams prevention. He estimates that £10 billion a year may be taken from citizens without their full understanding and consent, and not always by criminals.

Brown cites clear evidence of legitimate companies targeting and repeat selling to vulnerable individuals. He highlights the gap in the protective measures offered by the current definition of mental capacity. People in the early stages of dementia have some form of cognitive impairment, but do not lack capacity as defined by the Mental Capacity Act. Yet they are clearly more vulnerable than the average citizen. Brown cites his own mother, who paid over £3000 for unnecessary vitamin D supplements, and £600 to have her front drive spray-cleaned with a pressure hose, leaving sand all

[…..] Read More

Breast Screening – Is it worth it?

Choosing whether to have breast screening is a complex decision for any woman, balancing the risks of benefit and harm. The program was introduced 30 years ago for those aged 50-70, using 3 yearly mammograms, which use X-ray imaging to find breast cancer before a lump can be felt. However, it wasn’t until a review in 2012 that women were given proper information about the downside instead of the patronising ‘have screening, it’s good’ government line. The Marmot review found that for every 1,000 women screened over 20 years, about 5 breast cancer deaths are prevented at the expense of around 17 women being diagnosed and treated for a cancer that would never have caused them any problem. Furthermore, more than 200 women will experience significant psychological distress, anxiety and uncertainty because of false positive findings. And to make matters more confusing, the overall death rate from ‘all causes’ does not improve with screening. The lives saved from screening are balanced by the lives lost through overtreatment from X-ray exposure, surgery, chemotherapy and radiotherapy. In addition, screening doesn’t pick up all cancers and some women die at the same age of unrelated causes

[…..] Read More